Random inspection report
Care homes for older people
Name: Address: Morecambe Bay Care Home Gleneagles Drive Off St Andrews Grove Morecambe Lancashire LA4 5BN one star adequate service 03/11/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Marie Cordingley Date: 0 5 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Morecambe Bay Care Home Gleneagles Drive Off St Andrews Grove Morecambe Lancashire LA4 5BN 01524400255 Telephone number: Fax number: Email address: Provider web address: morcambe.bay@sshc.co.uk Name of registered provider(s): Name of registered manager (if applicable) Four Seasons (No 7) Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 87 Number of places (if applicable): Under 65 Over 65 0 87 0 dementia old age, not falling within any other category physical disability Conditions of registration: 87 0 87 The registered person may provide the following category of service only: Care Home with nursing - Code N. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. Dementia - Code DE. Physical disability Code PD. The maximum number of service users who can be accommodated is: 87. Date of last inspection 0 6 0 1 2 0 1 0 Care Homes for Older People Page 2 of 10 Brief description of the care home Morecambe Bay Care Home is owned and managed by Four Seasons, a company that operates a number of care services at various locations throughout the United Kingdom. Morecambe Bay Care Home is a Care Home with Nursing; it consists of 4 self-contained units. Torrisholme House and Bare House each offer care for 20 older people with Dementia. All bedrooms are single and located around a landscaped courtyard. Grange House offers 30 ensuite bedrooms to older people who require nursing care. Cartmel House is registered to care for up to 17 adults with a physical disability. Each of the 4 units are staffed separately, with a qualified nurse in charge of each unit. There is an acting manager in post at the home. Morecambe Bay Care Home is situated relatively close to the Promenade in Morecambe. Each of the units/houses within the centre have their own lounge and dining room and other facilities, for example, bathrooms and toilets. Each unit is on the ground floor offering easy access to all the facilities. Only the central part of the home has a first floor where the Managers office is located and the administration office for the home. The staff room is also located on the first floor. Care Homes for Older People Page 3 of 10 What we found:
This random inspection included an unannounced site visit. As the visit was unannounced, residents, staff and the manager did not know it was going to take place until we arrived. During the visit we spoke with a number of staff and the deputy manager of the home and also viewed a selection of documentation including staff rotas and a sample of residents care plans. We observed staff going about their duties and the care provided to residents. We also carried out a tour of some areas of the home. The purpose of the inspection was to assess progress made by the home in meeting requirements made at the key inspection in November 2009 in relation to staffing levels. We had also received information from a number of sources to indicate that the home were in breach of the Care Homes Regulations 2001 in relation to the provision of adequate numbers of staff. What the care home does well: What they could do better:
We spent time on each of the units for people who have Dementia. We observed staff going about their duties and noted that staff appeared to be under a great deal of pressure. One of the units we observed was home to 16 highly dependent residents, the majority of who required two carers to assist them with mobilising and personal care. As there were only two carers and one nurse on duty (who was attempting to complete a medication round and assist some residents with breakfast) this resulted in long periods of time where some residents were left unsupervised. At one point we witnessed a resident who was in a communal area unsupervised nearly fall. We later viewed her care plan which stated that she was at high risk of falls and needed to be closely monitored at all times. On the other unit which had 14 residents, we observed one resident who appeared to be in a great deal of distress. The resident was very vocal and was calling out for quite some time. However, there were no staff available to assist her for almost an hour. We later viewed this residents care plan which stated that when showing signs of distress in this manner, she should be provided with one to one time with carers which would help reassure her. When we spoke with a carer about this we were advised That sort of support is exactly the sort of support we cannot offer at this home. On both units for people with Dementia we witnessed the nurses on duty have to break
Care Homes for Older People Page 4 of 10 off from their medication rounds to provide assistance to various people who needed it. Rotas showed that the staffing levels we found during our unannounced visit were fairly typical. We spoke with several staff members who all told us that they felt the staffing levels were not adequate to meet peoples needs. One person stated We constantly have to prioritise, when there are only two of us and every resident needs us both to help them you have to make decisions all the time about who to help and who not to help. Another carer said I feel constantly compromised. It is horrible that we cant just sit and have a friendly chat with people, sometimes thats all they want, but we just dont have the time. Staff also expressed concerns about meal times. One carer advised us that there were seven residents who required assistance to eat on her unit and that there were usually only two staff available for this task. She explained that this meant that people frequently had to wait for their meals. We were also aware on the morning of our visit that one resident had assisted another resident to eat their breakfast. The Commission had previously advised the provider of the home that there must be processes in place to deal with short term unexpected staff absence such as sickness. We could find no evidence that this had been actioned. In viewing rotas we were extremely concerned to find that one staff member had just days earlier, worked a 24 hour waking shift. One carer made the comment You just cannot give the best to residents when you are exhausted. On the day of our visit a staff member from the catering team had rang in sick and the deputy manager was unable to find a replacement. As a result the residents menu had to be changed at the last minute and some people were not given the meal they had chosen and were expecting. We were also concerned to note an extremely high use of agency staff on the homes older peoples unit. There were 25 residents on this unit at the time of our visit, many with a high level of health care needs. In viewing rotas we were concerned to note that the night nurse shift for this unit had been almost entirely staff by agency nurses for a period of two months. High use of agency staff means that residents do not receive continuity of care and often receive their care from people they do not know. We also noted some examples on rotas where there had been no nurse on duty on this unit for periods of several hours. During this visit we also wanted to assess the homes progress in meeting a requirement in relation to the appropriate recording of external preparations (creams) administered to residents and a requirement made that the home follow correct procedures in safeguarding people from abuse. We spoke with the deputy manager regarding the recording of external preparations and were advised that a new system had been implemented but with limited success. The deputy manager advised us that a new and improved system was due to be implemented the day after our visit. As such, we have assessed that this requirement is still outstanding. Information relating to safeguarding was not available at the time of our visit. The manager of the home has been asked to forward the information to us as soon as
Care Homes for Older People Page 5 of 10 possible. We have noted that this requirement is still outstanding until the necessary information is received. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 9 13 All medication including prescribed external preparations e.g. creams must be administered as prescribed and their use supported by clear and accurate recored keeping. to help ensure peoples health and wellbeing. 30/04/2010 2 18 13 The homes safeguarding 03/12/2009 procedures must be followed at all times. This is to help ensure the safety and wellbeing of people using the service. 3 27 18 It must be ensured that 03/12/2009 there are adequate numbers of staff on duty at all times to meet the needs of residents. This is to help ensure the safety and wellbeing of people using the service. 4 31 8 The provider must propose a 03/05/2010 suitably qualified and experienced manager for registration with the Commission. This is to help ensure that Care Homes for Older People Page 7 of 10 Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action the home is managed effectively. 5 38 13 Unnecessary risks to the health and safety of people who live at the home must be identified and minimised. This is to help ensure the safety and wellbeing of people who live at the home. 10/11/2009 Care Homes for Older People Page 8 of 10 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
